Oshima Iwao, Sono Tamaki, Bond Gary R, Nishio Masaaki, Ito Junichiro
Graduate School of Social Welfare, Japan College of Social Work.
Psilocybe Inc.
Psychiatr Rehabil J. 2014 Jun;37(2):137-43. doi: 10.1037/prj0000085.
The individual placement and support (IPS) model of supported employment has been implemented throughout North America and Europe, with multiple randomized controlled trials documenting its effectiveness, but it has not been widely implemented in Asia. To date, no rigorous evaluations of IPS have been conducted in Japan. We sought to evaluate whether IPS could be implemented in Japan and produce superior competitive employment outcomes compared with conventional vocational services.
We employed a randomized controlled trial with a 6-month follow-up; 18 participants were randomly assigned to IPS and 19 to conventional vocational services. We assessed competitive employment rates, hours and weeks worked, and wages earned.
Over the 6-month follow-up period, IPS participants were more likely than those in usual care to work competitively (44.4% for IPS vs. 10.5% for controls, p = .022), work more hours (mean of 168 hr for IPS vs. 41 hr for controls, p = .002), and work more weeks (mean of 6.4 weeks for IPS vs. 1.8 weeks for controls, p = .003).
IPS can be implemented in Japan and yield better competitive employment outcomes than conventional vocational services. Adoption of the IPS model might have a dramatic impact on the mental health service system in Japan where psychiatric hospitals play a central role in mental health care.
支持性就业的个体安置与支持（IPS）模式已在北美和欧洲各地推行，多项随机对照试验证明了其有效性，但在亚洲尚未得到广泛实施。迄今为止，日本尚未对IPS进行过严格评估。我们试图评估IPS是否能在日本实施，并与传统职业服务相比产生更优的竞争性就业成果。
我们采用了一项为期6个月随访的随机对照试验；18名参与者被随机分配至IPS组，19名被分配至传统职业服务组。我们评估了竞争性就业率、工作时长和周数以及所获工资。
在6个月的随访期内，IPS组参与者比接受常规护理的参与者更有可能从事竞争性工作（IPS组为44.4%，对照组为10.5%，p = 0.022），工作时长更多（IPS组平均为168小时，对照组为41小时，p = 0.002），工作周数更多（IPS组平均为6.4周，对照组为1.8周，p = 0.003）。
IPS可以在日本实施，并且比传统职业服务产生更好的竞争性就业成果。采用IPS模式可能会对日本的精神卫生服务系统产生巨大影响，在日本，精神病院在精神卫生保健中发挥着核心作用。
